International Endodontic Journal
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Assessment of a gel‐type chelating preparation containing 1‐hydroxyethylidene‐1, 1‐bisphosphonate Abstract Aim To test an aqueous gel containing 1‐hydroxyethylidene‐1, 1‐bisphosphonate (HEBP) regarding its interactions with sodium hypochlorite, its calcium binding capacity, and its potential in preventing the formation of a smear layer when used in conjunction with rotary root canal preparation.Methodology The experimental aqueous gel consisted of (w/v) 2% alginate, 3% aerosil, 10% Tween 80 and 18% HEBP. Interactions of gel components with hypochlorite were assessed using iodometric titration and monochromatic ultraviolet spectrometry. Two commercial paste‐type chelators containing ethylenediaminetetraacetic acid (EDTA) and peroxide (RC‐Prep and Glyde) served as controls. Calcium‐binding capacities were measured in mixtures with a Ca2+ standard solution buffered at pH 10 using a calcium‐selective measuring chain. Finally, root canals of 16 extracted single‐rooted premolars per group were instrumented using ProFile instruments dipped in the experimental gel, RC‐Prep, or nothing. Additionally, canals were rinsed with 10 mL of a 1% NaOCl solution during/after preparation. Smear scores in instrumented teeth were monitored using scanning electron microscopy.Results None of the experimental gel components showed short‐term interactions with hypochlorite, whilst EDTA, peroxide, RC‐Prep and Glyde immediately reduced the hypochlorite in solution. The experimental gel chelated 30 mg Ca2+ g−1 , compared with 16 mg Ca2+ g−1 and 11 mg Ca2+ g−1 chelated by RC‐Prep and Glyde respectively. Smear scores obtained with the experimental gel were significantly (P < 0.05) lower than with RC‐Prep in coronal and middle root thirds, whilst no differences were observed in apical root thirds.Conclusions Under the conditions of this study, an HEBP gel appeared advantageous over currently available products.
International Endodontic Journal - Tập 38 Số 11 - Trang 810-816 - 2005
Irisin promotes odontogenic differentiation and angiogenic potential in human dental pulp cells Abstract Aim To determine whether irisin, a newly discovered myokine that links exercise‐induced and metabolic homeostasis, is able to promote odontogenic differentiation and angiogenesis in human dental pulp cells (HDPCs). Methodology Cell viability in the presence of irisin was measured. Real‐time PCR and Western blot analysis were performed to evaluate the expression levels of irisin, odontogenic and angiogenic markers. The involvement of mitogen‐activated protein kinase (MAPK) and the protein kinase B (Akt) signalling pathway was evaluated by Western blot. To evaluate mineralization nodule formation, alkaline phosphatase (ALP) staining and alizarin red S staining were performed. Scratch wound assays were performed to evaluate the effects of irisin on cell migration. The data were analysed using one‐way analysis of variance (anova ) followed by Tukey post hoc test and Student’s t ‐test. Statistical significance was considered at P < 0.05. Results Irisin significantly promoted odontogenic differentiation as evidenced by formation of mineralized nodules, induction of ALP activity and upregulation of odontogenic and angiogenic markers (P < 0.05). Scratch wound assays revealed that irisin significantly increased migration of HDPCs (P < 0.05). Phosphorylation of both MAPK and Akt was increased by irisin. MAPK and Akt inhibitors inhibited mineralization, cell migration and the increased expression of odontogenic and angiogenic markers. Conclusions Irisin promoted odontogenic differentiation and mineralization and has the potential for angiogenesis through activation of the MAPK and Akt signalling pathways in HDPCs.
International Endodontic Journal - Tập 54 Số 3 - Trang 399-412 - 2021
Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study Summary. An apical dentine sampling technique was applied in order to monitor the bacteriology of the pulp canal and radicular dentine before and during treatment of teeth with chronic apical periodondtis. Twenty‐three teeth with a radiographic diagnosis of apical periodontitis were studied. They were subjected to a standardized two‐appointment treatment regimen of extensive apical reaming in the absence of antimicrobial agents and 1‐week dressing with calcium hydroxide. Bacteriological samples were taken from the root canal at the start, and apical dentine samples at the end, of each sitting. Provision was made to allow growth of anaerobic bacteria. All root canals but one showed growth at the start of treatment. Dentine samples were positive in 14 of the 23 teeth at the end of the first appointment. Eight of the 23 canals had detectable growth from the canal at the start of the second appointment, but in sufficient numbers for quantification in only one root canal. The subsequent dentine sampies were otherwise negative at the second appointment. There was a tendency for teeth causing symptoms to harbour more bacteria than symptomless teeth.
International Endodontic Journal - Tập 24 Số 1 - Trang 1-7 - 1991
Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis
International Endodontic Journal - Tập 30 Số 5 - Trang 297-306 - 1997
Microbiological status of root‐filled teeth with apical periodontitis The present study examined the microbiological status of 100 root‐filled teeth with radiographically verified apical periodontitis — the pathology (P) group — and of 20 teeth without signs of periapical pathosis — the technical (T) group. In the P group 117 strains of bacteria were recovered in 68 teeth. In most of the cases examined one or two strains were found. Facultative anaerobic species predominated among these isolates (69% of identified strains). Growth was classified as ‘sparse’ or ‘very sparse’ in 53%, and as ‘heavy’ or ‘very heavy’ in 42%. Enterococci were the most frequently isolated genera, showing ‘heavy’ or ‘very heavy’ growth in 25 out of 32 cases (78%). In 11 teeth of the T group no bacteria were recovered, whilst the remairling nine yielded 13 microbial strains. Eight of these grew ‘very sparsely’. It is concluded that the microflora of the obturated canal differs from that found normally in the untreated necrotic dental pulp, quantitatively as well as qualitatively. Nonsurgical retreatment strategies should be reconsidered.
International Endodontic Journal - Tập 31 Số 1 - Trang 1-7 - 1998
Autotransplantation of an ectopic impacted premolar with sinus lift and allogenic bone graft
International Endodontic Journal - Tập 44 Số 10 - Trang 967-975 - 2011
New perspectives on radicular cysts: do they heal? During the past few decades several authors have perpetuated the notion that nearly half of all periapical lesions are radicular cysts. A few studies, based on meticulous serial sectioning of periapical lesions retrieved in toto , have shown that the actual incidence of radicular cyst is only about 15% of all periapical lesions. Equally significant was the discovery in 1980 and recent confirmation that radicular cysts exist in two structurally distinct classes namely, those containing cavities completely enclosed in epithelial lining (periapical true cysts) and those containing epithelium‐lined cavities that are open to the root canals (periapical pocket cysts). From a clinical point of view a periapical pocket cyst may heal after conventional root canal therapy whereas an apical true cyst is less likely to be resolved without surgical intervention.
International Endodontic Journal - Tập 31 Số 3 - Trang 155-160 - 1998
External cervical resorption – Treatment outcomes and determinants: A retrospective cohort study with up to 10 years of follow‐up Abstract Aim To assess long‐term external cervical resorption (ECR) treatment outcomes in relation to both local and treatment‐related determinants. Methodology Information was available for 76 patients (98 teeth) who were diagnosed with ECR during the period from 2008 to 2018 at the University of British Columbia graduate endodontics clinic. The ECR patients were followed up, and a clinical and radiographic examination was conducted. Chi‐square test compared failure rates amongst different subgroups. The survival analysis was used to evaluate the overall ECR survival/failure rates in relation to several local and treatment‐related determinants. Results Overall, 67 patients (89 teeth) were followed up. The mean follow‐up time was 3.9 years, and the minimum was 1 year. Twenty‐four teeth failed (19 extracted, 5 not functional), and the overall probability of failure was 50.0% 8 years after the diagnosis. Significant (p < .05) local ECR determinants were tooth location and the Heithersay classification, and treatment‐related determinants were root canal treatment (RCT) and the ECR repair combined with RCT. Treatment outcomes for Heithersay class 1 and 2 cases were better than for class 3 and 4 cases. Conclusions Higher failure rates were associated with posterior tooth location and higher Heithersay class, whilst RCT and ECR repair combined with RCT were associated with lower failure rates.
International Endodontic Journal - Tập 55 Số 5 - Trang 441-452 - 2022
The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography – an <i>in vivo</i> investigation Abstract Aim To compare the accuracy of intraoral periapical radiography with cone beam computed tomography (CBCT) for the detection and management of resorption lesions.Methodology Digital intraoral radiographs and CBCT scans were taken of patients with internal resorption (n = 5), external cervical resorption (n = 5) and no resorption (controls) (n = 5). A ‘reference standard’ diagnosis and treatment plan was devised for each tooth. Sensitivity, specificity, positive predictive values, negative predictive values and receiver operator characteristic (ROC) curves, as well as the reproducibility of each technique were determined for diagnostic accuracy and treatment option chosen.Results The intraoral radiography ROC Az values were 0.780 and 0.830 for diagnostic accuracy of internal and external cervical resorption respectively. The CBCT ROC Az values were 1.000 for both internal and external cervical resorption. There was a significantly higher prevalence (P = 0.028) for the correct treatment option being chosen with CBCT (%) compared with intraoral radiographs (%).Conclusion CBCT was effective and reliable in detecting the presence of resorption lesions. Although digital intraoral radiography resulted in an acceptable level of accuracy, the superior accuracy of CBCT may result in a review of the radiographic techniques used for assessing the type of resorption lesion present. CBCT’s superior diagnostic accuracy also resulted in an increased likelihood of correct management of resorption lesions.
International Endodontic Journal - Tập 42 Số 9 - Trang 831-838 - 2009
External cervical resorption: part 2 – management Abstract Effective management of external cervical resorption (ECR ) depends on accurate assessment of the true nature and accessibility of ECR ; this has been discussed in part 1 of this 2 part article. This aim of this article was firstly, to review the literature in relation to the management of ECR and secondly, based on the available evidence, describe different strategies for the management of ECR . In cases where ECR is supracrestal, superficial and with limited circumferential spread, a surgical repair without root canal treatment is the preferred approach. With more extensive ECR lesions, vital pulp therapy or root canal treatment may also be indicated. Internal repair is indicated where there is limited resorptive damage to the external aspect of the tooth and/or where an external (surgical) approach is not possible due to the inaccessible nature of subcrestal ECR . In these cases, root canal treatment will also need to be carried out. Intentional reimplantation is indicated in cases where a surgical or internal approach is not practical. An atraumatic extraction technique and short extraoral period followed by 2‐week splinting are important prognostic factors. Periodic reviews may be indicated in cases where active management is not pragmatic. Finally, extraction of the affected tooth may be the only option in untreatable cases where there are aesthetic, functional and/or symptomatic issues.
International Endodontic Journal - Tập 51 Số 11 - Trang 1224-1238 - 2018
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